Third ventricular metastasis

Presentation

Patient Data

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Axial T1

Within the 3rd ventricle is a well-circumscribed enhancing mass which measures 22 x 31 x 22 mm. It is associated with edema in the thalamus bilaterally, and seems to impede the outflow of the ventricles to some degree, as are temporal horns are slightly prominent, but without significant hydrocephalus. It is an isolated abnormality, with no other enhancing lesions seen elsewhere within the brain.

Conclusion: Third ventricular mass, in a patient with a large pulmonary mass and mediastinal nodes almost certainly represents a metastasis, presumably from a lung primary.

Case Discussion

The patient went on to have a CT of the chest which demonstrated a large left upper lobe central tumor that measures 7 cm in size, encasing the left upper lobe bronchus and invading the mediastinum directly. There are several large upper mediastinal lymph nodes which measure up to 2.4 cm, but no enlarged subcarinal lymph node. The patient went on to have the chest lesion biopsied (transbronchial needle aspiration - TBNA).